In our clinic, we live by and provide care based on 3 overarching principles or rules: 
If you want to get out of pain…
 
  1. STOP hurting it
  2. DO things that help it
  3. No amount of #2 can overcome disobedience to #1

These are the FIRST 3 steps to getting out of pain.

A Painful Example

Think about what happens when you hit your hand with a hammer (or some similar situation). What do you feel first? It’s not pain. It’s pressure. Then you know that pain will soon arrive, and it does. What are you doing at this point? (I mean besides dropping the hammer, yelling, and cursing.) You are holding and squeezing the spot that you hit (putting pressure on it). Perhaps you’re even dancing around. Curious. What you’re doing is intelligent (though it may not appear that way). You’re trying to give your brain extra stimulus that is different than pain. The more nerves that you can excite that don’t relate to pain the less pain you will feel!
 
There are two main types of nerves in your body. Those that make things happen (efferent) are motor neurons. Those that tell what is happening (afferent) are sensory neurons. Of the sensory neurons, there is a host of nerves to detect different sensations: movement, position, pressure, vibration, temperature, and pain. The ones designated to pain are nociceptors.

STOP hurting it – Red Lights

If you are to get out of pain we must identify in your life the “red lights” that are keeping you in pain. A wound cannot heal when the scab is continually picked. Staying away from pain triggers is THE MAIN key to overcoming pain and allowing the body to heal.
 
In our story, you activated the nociceptors of your hand. They alerted your brain to the threat of tissue damage by sending you pain. Pain is a great motivator and was effective in preventing you from hitting your hand again. This was your brain’s way of giving you a RED LIGHT.
 
Your first task is to create a RED LIGHT LIST of all the things that cause you pain. Be as specific and descriptive as you can. If you are vague and say “golfing” but love to golf…well, that’s not so fun. How about, “during my downswing with my irons” or “while I’m putting”. Now we’re in business and with some modifications, we can keep you golfing!
 
Look for trends and patterns. Is it worst in the morning and gets better from there? Do you begin each day feeling okay and the pain comes on throughout the day? Is it only when you’re sitting in your favorite chair? Is it when you’re walking, standing, moving? Or is it when you stop, sit, lie down? Does the pain travel? Where to? Down an arm? Down a leg? How far? Which fingers/toes?
 
It may take a few days to create your list. That is fine. Become more aware of your life and where pain arises. Add to your list as you make new discoveries.

DO things that help it – Green Lights

Next, you will make another list. A GREEN LIGHT LIST. Put here any activities that DECREASE the pain. Sitting, lying, standing, walking? Staying active? Sleeping on your side with a pillow between the knees or on your back with a pillow under the knees? Try to find things that are specific to positions, postures, loads, and movements rather than ice, heat, pain meds, etc. These mask pain rather than actually getting rid of it.
 
Compare your lists and see if there are common trends that separate the two lists. You’re figuring out how to get better! This is exciting!!!
 
If you can fill your life with more green than red you can allow your sensitivity to pain to decrease. When you’re in pain you are more sensitized to it!!! As you stay away from it you normalize and find it easier to be pain-free. After you smashed your finger with the hammer you introduced other sensations that were relieving, or at least different. So it covered up the pain to a degree. 
 
There will likely be another category of things that do not increase or decrease your pain. Things that you can do pain-free. These are YELLOW LIGHTS. We can live in the yellow and coast through our days this way. That’s a great place to be. 
 
If you can spend more time without triggering the pain it will go away and your body will heal! It will take time.
 
I’ll add here that the green lights available to you now will not be enough for tomorrow. What I mean is that the good things you have to do need to grow and increase. You’ll want to become better than good. Increase your strength and endurance. I’m a huge advocate of strength training for everyone. I believe everyone should learn how to deadlift and squat. What about grandmas? Wanna pick up your sweet grandkids? Learn to deadlift and squat! Nobody on this planet would be at a disadvantage by gaining strength. If you could squat with a barbell loaded with your bodyweight do you think cleaning toys off the floor would hurt your back? Yeah, me neither.

No amount of #2 can overcome disobedience to #1

If you’re driving and obeying the law only crossing intersections when the light is green (and rolling through the occasional yellows) you are a ‘good driver’. Good drivers don’t get tickets. However, if you run a red light you will either cause an accident or get pulled over – assuming karma deals with you justly. When the police officer comes to the window you’ll tell him that you’re a ‘good driver.’ Then you’ll speak about all the green lights that you’ve gone through. Know what will happen then? He’ll give you a ticket that will have a nice fine you’ll have to pay.
 
This is the case with pain and healing. It doesn’t matter how much good you do if you keep screwing things up. It comes down to the positions, postures, and loads that we default to. This means that you have to change your habits. Examine the way you live your life. If you fall into the category of “I can’t think of anything” or “I don’t do anything to hurt it – it just does”. Then you are likely a culprit of poor posture and faulty movement patterns. There is a reason and it’s up to YOU to identify it and understand it, then modify it or eliminate it. It requires constant and continual vigilance.
 
A great way to make a painful thumb remain painful, or become worse is to keep hitting it with a hammer. Eventually, even the slightest pressure will produce intense pain – regardless of the nice things you do for it. 
 
Good overcomes bad, yet that doesn’t mean that adding dirt to water won’t make it muddy. The good has to REPLACE the bad. They can’t coexist. And it doesn’t happen immediately; so be patient. There is no easy fix, or gimmick, or product, or drug, or surgery that works without fail! Beware of promises that you will be fixed forever and it will happen fast. You’ll also be sold that you are so bad you will need to be seen many times a week for many months – years – the rest of your life… Active care will be more important than passive care. Active care means it’s done BY you. Passive care means it is done TO you. Active care is more or less free! Passive care can be very costly. You are the guardian of your health and like Nacho you can have your glory day without pain.
“I am the gatekeeper of my own destiny and I will have my glory day in the hot sun.” – Nacho LibreControl your back pain
Sometimes we do need surgery and medication (usually we don’t). Sometimes there is much to be gained from passive therapies. I love a good adjustment – hello, it’s my main tool! It offers so much benefit and does so quickly. It helps you to move better so that you can find more green lights. The red lights still exist though and no amount of adjusting, massaging, stretching, etc. will change that.
 
Even if you follow my dream for you and you get to the point where you can squat more than you weigh but you run red lights… Welp, you deserve what you get for breaking the rules.
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